Hirsutism

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Hirsutism
Body Parts: Head Limbs Chest Back Abdomen
Medical Subjects: Skin
Overview

What Is Hirsutism

What is hirsutism?

Hirsutism mainly refers to the increase in the number of women's hair.

Performance for the upper lip long beard, serious person ear, cheek, chin hair also increased (commonly known as beard), chest, back, lower abdomen, arms and thighs appear too much too close hair (commonly known as fine hair), like men's hair distribution characteristics.

Sometimes there will be a male tendency, such as: Adam's apple increases, a deep voice, but in women, this hairy hair seriously affect the beautiful.

The etiology of hirsutism is complex, with elevated androgen levels being the main cause of hirsutism in women and also in some patients' homes.

The key to the treatment of hirsutism is to identify the cause of hirsutism. It mainly includes medical treatments such as finasteride, spironolactone, cyproterone acetate, bromocriptine and metformin, and can also be combined with cosmetic treatments such as laser hair removal, plucking and shaving.

Many people with hirsutism?

In China, 8%–15% of women suffer from hirsutism, and the incidence is relatively high in China with a large population.

Is hirsutism a hairy child?

No.

Hairy child, also known as congenital pilia and congenital pilia, is a rare hereditary disease.

It is caused by the inability to be replaced by filiform hair.

At birth, the child suffers from hirsutism, with fine and soft fur, which will gradually grow thicker and larger later. With longer eyelashes, bushy eyebrows, and serious face, the child looks like a dog's face or a monkey's face, sometimes accompanied by abnormal teeth and ear deformities.

Cause

What Is The Cause Of Hirsutism

What causes hirsutism?

It is mainly related to race, hormone level and sensitivity to hormone.

  • Race, gender, etc: Europeans have thicker hair than Asians and men have longer, thicker and denser hair than women, but they are not hirsutism.
  • Androgen level: Hair is like a seed. Androgen (mainly free testosterone) is like soil nutrients. Excessive nutrients lead to excessive "rooting and sprouting" of hair. Androgen mainly acts in the form of testosterone in the body, and only free testosterone has activity. Diseases such as pituitary gland, adrenal gland, ovary, and liver as well as genetic and other reasons cause an increase in androgen level, further resulting in an increase in free testosterone, and eventually an increase in the number of hairs.
  • Hair follicles in patients with hirsutism are more sensitive to androgens, so a slight irritation with androgens can result in an increase in hair count.

Which organs or tissues can secrete androgens in women?

Pituitary, adrenal, ovarian, ectopic endocrine tumors such as gastric cancer, duodenal cancer, lung cancer, and choriocarcinoma.

In whom is hirsutism likely to occur?

It can occur in women from childhood to adulthood, and the common hirsutism mainly refers to the hairy of women.

Is hirsutism contagious?

Absolutely not infectious, hirsutism is not an infectious disease, and sometimes people with hirsutism have hair that is uncomfortable or even creepy, but not contagious at all.

Is hirsutism hereditary?

Most hirsutism patients are not related to heredity, but some hirsutism patients have definite relatives with similar diseases in their family, and this part of patients is related to heredity.

In what circumstances may hirsutism be inherited?

  • When one of the patients' parents is ill or both parents are ill, these patients get sick because of heredity and can be ill for both men and women, regardless of gender.
  • At least half of a patient's children are genetically affected.
Symptom

What Are The Symptoms Of Hirsutism

What are the types of hirsutism?

Androgenism is a major cause of hirsutism and can occur for a variety of reasons.

  •  
  • Pituitary hirsutism (the pituitary gland is a gland that secretes hormones that stimulate increased androgen secretion)
  • Adrenal hirsutism (adrenal glands are a pair of organs, and their problems cause increased androgen secretion)
  • Ovarian hirsutism (small amounts of androgen are normally secreted by the ovary)
  • Constitutional hirsutism (also known as cutaneous hirsutism, as the name implies, is related to constitution)
  • Hepatogenic hirsutism (increased testosterone caused by liver diseases such as cirrhosis of liver and hypohepatia, which is the main component of androgen and has the greatest function)
  • Ectopic hormone producing hairy disease (such as lung cancer, gastric cancer, choriocarcinoma and other endocrine changes involved in androgen secretion increased)
  • Iatrogenic (such as long-term heavy hormone use) hirsutism
  • Hirsutism, familial hirsutism due to failure of conversion of external Zhou Xiong hormone to estrogen.

What are the manifestations of pituitary hirsutism?

Pituitary gland (pituitary gland is a kind of gland, belongs to the headquarters, it secretes hormone command androgen secretion increases) adenoma and so on lead to the pituitary gland secretion of adrenocorticotropic hormone (ACTH) and prolactin increases, stimulate the androgen secretion increases.

  • It often happens to women under the age of 50.
  • Clinical manifestations include no menstruation, whelk, galactorrhea (non-pregnant and non-lactating, with liquid flowing out from nipples when being squeezed), infertility, hairy face middle and cheek, and male pattern alopecia (thin and dry hair and smooth scalp in alopecia area, and it often occurs in the overhead area).
    It is accompanied by severe seborrheic dermatitis, which is easy to occur on the head and face, and even on the chest and back. The skin manifestations of seborrheic dermatitis include greasy scaly yellow and red patches, with clear boundary and symmetrical distribution. It is often accompanied by itching to different degrees, which is easy to repeatedly attack.

What are the manifestations of adrenal hirsutism?

Adrenal gland (adrenal gland is a pair of organs, can secrete androgen, its problem can make androgen secretion increases) hyperplasia and adrenal adenoma and cancer cause androgen level increases.

She was muscular, lost her feminine curves, had flat hips, and presented with virilizing symptoms, prominent Adam's apple, and no menses. The diseased skin presents with acne, seborrheic dermatitis, severe hirsutism, and male pattern alopecia (thin, dry hair in the alopecia area, smooth scalp, and often occurs in the overhead area).

What are the manifestations of ovarian hirsutism?

It is divided into non-neoplastic hairy ovary and neoplastic hairy ovary as follows:

  • Ovarian non-neoplastic hairy, divided into two categories:
  • Polycystic ovary syndrome: one of the most common causes of hirsutism and one of the most common endocrine disorders in gynecology, it is an interdisciplinary disease.
    The enlargement of the ovary secretes excessive androgens. Clinical manifestations include hairy, whelk, irregular menstruation or menopause, uterine bleeding, ovulation failure, small breast and obesity.
  • Increased number of ovarian theca cells (which are the constituent cells of the ovary and secrete androgens): The disease has a higher level of androgen secretion and shows marked virilization, muscular development, male tone, clitoral enlargement, hairy breasts and both sides of the face, etc.
  • Ovarian neoplastic hirsutism: It occurs between the ages of 20 and 40. For elderly women, especially those who suffer from hirsutism after menopause, we should be more alert to the possibility of ovarian tumors.
    The tumor started to progress quickly. Clinical manifestations include virilization, muscular development, male tone, clitoral enlargement, and hairy breasts and both sides of the face.

What are the manifestations of constitutional hirsutism?

Clinical manifestations include severe whelk, hairy on both sides of face and breast, shortened or prolonged menstrual period or normal, male pattern alopecia (thin and dry hair in alopecia area, and smooth scalp, which often occurs in the overhead area), and seborrheic dermatitis.

Although skin lesions were present, the absence of substantial hormonal abnormalities, the absence of anovulatory menstrual cycles, and the absence of ultrasound evidence of polycystic ovaries were a diagnosis that excluded other organs and glands.

16 ~ 20 years old women and many thin young women, work and study and physical and mental pressure, can appear constitutional hirsutism.

What are the manifestations of hepatogenic hirsutism?

Hepatic origin, that is, hepatic lesions as the source or cause. Live lesions such as live cirrhosis and hypohepatia produce less sex hormone binding globulin, less bound testosterone and more free testosterone.

Hair is like a seed, and androgens (mainly free testosterone) are like nutrients in the soil. Excessive nutrients lead to excessive "rooting and sprouting" of hair, resulting in hairy.

In addition to hairy manifestations, patients may have liver function abnormalities (which require laboratory tests) and liver disease manifestations (different liver diseases can have different manifestations, requiring specific consultation with a specialist).

What are the manifestations of ectopic hormone-producing hirsutism?

Some tumors (such as gastric cancer, duodenal cancer, lung cancer, and choriocarcinoma) can produce and secrete hormones or hormone-like substances (normally hormones are secreted by endocrine glands such as the pituitary gland and adrenal gland), causing symptoms of endocrine disorders.

This kind of tumor is called ectopic endocrine tumor, and the hormone it secretes is called ectopic hormone.

Gastric cancer, duodenal cancer, lung cancer (especially small cell lung cancer) and choriocarcinoma, etc., secrete a hormone similar to that of the pituitary gland, resulting in increased secretion of androgens, hirsutism, and lesions caused by the tumor itself.

  • Gastric cancer: upper abdomen uncomfortable, no appetite, stomach pain, even stomach bleeding and melena, etc.
  • Duodenal cancer: upper abdomen uncomfortable, pain after eating, nausea, vomiting, black stool, yellow skin, etc.
  • Lung cancer: cough, bloody sputum, difficulty in breathing, chest pain, etc.
  • Choriocarcinoma: Irregular bleeding of vagina after delivery or abortion, uterus failing to recover as scheduled, large and soft, etc.

Clinical manifestations include acne, obesity, irregular menstruation, menopause, hirsutism, and sometimes masculinity (such as hairy, long beard, enlarged Adam's apple, and low voice) and male pattern alopecia (thin and dry hair in the alopecia area, and smooth scalp, which often occurs in the overhead area).

What was iatrogenic hirsutism like?

Medical source, that is, long-term use of therapeutic drugs as an incentive. Most of these treatments are hormonal.

Long-term use of glucocorticoids, androgens and contraceptives with high progesterone content by women can cause hirsutism. Clinical manifestations include masculinity (such as hairy, long beard, enlarged Adam's apple, low voice, etc.), hairy face and back, irregular menstruation, and menopause.。

What are the manifestations of familial hirsutism?

Familial, that is, related to heredity, the rest of the family also have similar disease. It is characterized by excessive androgen secretion, insulin resistance and complete normalization of laboratory tests.

Clinical manifestations include facial hirsutism, prolongation of planting line for auricular hair, and no acne, seborrheic dermatitis, and male pattern alopecia (thin and dry hair in the alopecia area, and smooth scalp, which often occurs in the overhead area).

What's the harm of hirsutism?

The harm mainly manifests in the physiology and the psychology two aspects.

  • Physiological aspects: Many patients with hirsutism have acne, seborrheic dermatitis and male pattern baldness (thin and dry hair in the alopecia area, and smooth scalp, which often occurs in the overhead area) at the same time, which are skin manifestations that seriously affect face engineering and the main reason why they look at dermatology department.
  • Psychological aspects: we should know that every woman is born to love beauty. these patients are afraid of the taunts of classmates and colleagues around and are unwilling to associate with everyone. they even have anxiety and autism, which have seriously affected their work and study.
Detect

How To Check For Hirsutism

What tests are needed to diagnose hirsutism?

Patients with hirsutism need to carefully ask the onset time, masculinity (such as hairy, long beard, Adam's apple, deep voice, etc.), menstrual history, family history and ethnic background and other medical history, and then according to the situation of laboratory tests, mainly including:

  • Serum testosterone;
  • 17 alpha-hydroxy progesterone level;
  • Laboratory tests for some tumors (this depends on the condition).
Prevention

How To Prevent Hirsutism

How to prevent hirsutism?

The etiology of hirsutism is currently unknown, so there is no effective means to prevent it.

Treatment

How Is Hirsutism Treated

What department should hirsutism see?

Dermatology department and endocrinology department can do this. If the main manifestation is irregular menstruation, it is recommended to look at gynecology. Polychaeta is a disease that spans multiple departments, and occasionally requires joint diagnosis and treatment by multiple departments.

Can hirsutism be cured radically?

The vast majority cannot be cured.

  • Hirsutism caused by these diseases will disappear if these diseases (such as pituitary microadenomas and polycystic ovary syndrome) can be cured, but it will also appear if these diseases recur.
  • Iatrogenic (i.e., long-term use of therapeutic agents as an inducement) hirsutism may resolve after a period of drug discontinuation.
  • Familial (i.e. related to heredity and others in the family suffering from similar diseases) hairy because it is inherited, can not be cured.

How is hirsutism treated?

The key to treatment is to find out the cause of hirsutism and actively give the cause and symptomatic treatment. Specific treatments were as follows:

  • Cosmetic or mechanical treatment of that skin
  • Laser hair removal: It is currently applied widely and suitable for large-area hairy with high patient satisfaction.
  • Shaving: Applicable to hairy, but troublesome and time-consuming localized on the arms and legs.
  • Plucking: Applicable to small areas of hairy, but obvious pain, need to prevent infection.
  • Chemical depilatory: such as barium sulfide, but on the skin irritant, the effect is not ideal.
  • Medication: combination therapy is generally adopted, which is mainly divided into two types, with the details shown below:
  • Non-specific inhibition of androgen secretion by the ovary and adrenal gland: includes oral contraceptives, triptorelin, and glucocorticoids.
  • Anti-androgen drugs include cyproterone acetate, spironolactone, flutamide, finasteride, and cyproterone acetate.
  • Surgical treatment: Ovarian, pituitary and adrenal tumors requiring surgical treatment.

What precautions does hirsutism medicaments treatment have?

  • Cyproterone acetate: it is rarely used alone, and the effect is better when it is used in combination with estrogen. if the drug is used continuously for 4 to 9 months, the effect will be obvious. it should be used for a long time. due to the side effects of fetal malformation, we should pay attention to contraception during the use of the drug.
  • Spironolactone: A drug widely used for at least six months. The side effects include menstrual disorders, breast pain, high blood potassium level, and headache. Blood potassium needs to be regularly reviewed. Contraception needs to be noticed due to teratogenicity.
  • Flutamide: The effect is stronger, and the side effects include transient nausea, headache, dry skin, decreased libido, and liver injury. The liver function needs to be reviewed regularly according to the doctor's advice.
  • Finasteride: Less side effects, occasional headache, nausea, and decreased libido.
  • Cyproterone: it can take effect after being combined with estrogen for 3 months, with a general treatment course of 6–8 months. The side effects include menstrual cycle changes, decreased libido, fatigue, hypertension, and weight gain. Therefore, it cannot be used for patients with liver diseases.

How does laser therapy for hirsutism work?

Laser treatment of hirsutism is based on selective photothermal kinetics–specifically, the laser with the wavelength of 600–1200 nm can be effectively absorbed by melanin in hair roots and follicles, causing temperature rise in hair roots and damage to hair follicles for long-term alopecia.

What preparations are needed before laser hair removal for hirsutism?

  • Don't expose yourself to the sun for 2 weeks before treatment, such as going to the seaside for vacation.
  • Laser hair removal is not allowed for people who are sensitive or allergic to light.
  • Sensitive drugs such as Avi A capsule, sulfonamides and minocycline should not be eaten up in one week before treatment.
  • Patients were educated and informed of the precautions for laser hair removal before treatment. Those with high expectations for a treatment and unable to adhere to the course of treatment were not suitable for laser hair removal.

What are the instruments for laser hair removal in hirsutism? What are the pros and cons of each?

  • 755nm emerald laser:
  • The hair removal device has the advantages that the hair removal device is recognized as a relatively ideal hair removal wavelength, the long-term effective rate of hair removal can reach 65 to 80.6 percent, and the hair removal device is suitable for most patients.
  • Cons: cumbersome technology.
  • Semiconductor laser:
  • Advantages: The laser with longer wavelength is applicable to the skin with deeper complexion, and compared with the laser with shorter wavelength, the laser has less chance of generating adverse reactions such as pain and pigmentation after inflammation.
  • Disadvantages: Pain during treatment.
  • 1064nmNd:YAG laser:
  • It is considered to be the best choice for dark-skinned patients to remove hair, with good satisfaction.
  • The pain and inflammatory reaction during treatment were severe.
  • Strong pulse light:
  • Is a high intensity light source (multi-purpose xenon lamp) produced by the light, is a wavelength in the range of 400 ~ 1200 nm light, a wide range of applications, pain symptoms than emerald laser, more than semiconductor laser.
  • Disadvantages: The couplant needs to be applied during treatment, and the treatment head needs to be close to the skin, so the skin reaction during treatment cannot be observed in time.

Hirsutism at present formal medical institutions, what kind of laser hair removal treatment?

At present, strong pulse light and semiconductor laser are mostly used for hair removal in formal medical institutions.

Due to the high price of laser equipment, it is impossible for a hospital to buy all the laser hair removal equipment. 755nm emerald laser, semiconductor laser, 1064nmNd:YAG laser and strong pulse light can be seen in different regular hospitals.

The equipment in each hospital may be the same or different, just as each person may choose different shoe styles with the same purpose.

What are the adverse reactions of laser treatment for hirsutism?

  • Temporary adverse reactions include redness, pain, blistering, crust formation and temporary darkening, darkening, whitening, and unevenness of the skin. Timely and reasonable treatment such as cold compress and external application of antibiotic ointment can be continuously improved.
  • Permanent adverse reactions: Long-term skin becomes deeper, darker, whiter, less uniform, and has scars, which generally do not resolve.

What are the precautions for laser treatment of hirsutism?

  • Hirsutism caused by the disease is actively treated with laser treatment and familial hirsutism (that is, those related to heredity and others in the family suffering from similar diseases) can be depilated with laser.
  • Treatment of herpes, blisters, skin infections, skin ulceration, and light sensitive person, etc. Not suitable for laser treatment.
  • Three to five treatments are needed, with an interval of 1 to 3 months each time, because hair growth cycles are divided into growth, regression and resting periods, and satisfactory results can be achieved after multiple treatments.
  • Sun protection is required for at least one week after treatment.

Why do you need multiple treatments for laser treatment of hirsutism?

The hair growth cycle is divided into growth period, degenerative period and resting period. Laser hair removal in growth period is effective for 75% of hair, while in degenerative period it is 25%, but it is almost ineffective in resting period. Therefore, multiple treatment can achieve satisfactory results.

What is the effect of depilating, shaving and depilating cream used for hirsutism?

  • Hair removal: The pain is obvious, and it is easy to be infected. It needs to be removed one by one, which takes time.
  • Shaving: also known as shaving, easy to scratch, need to shave once every three or four days, time-consuming.
  • Depilatory cream: depilatory cream easily cause skin allergy, need to take off once a week or two.

Does the skin color of hirsutism get dark after laser treatment?

The vast majority do not, and very few patients have long-standing pigmented spots, namely, darkened, darkened or uneven skin, after treatment.

Hirsutism is caused by polycystic ovary syndrome, how to treat?

  • Medication: such as cyproterone acetate, spironolactone, flutamide, finasteride, and cyproterone acetate; it can reduce androgen level, adjust menstrual cycle, improve insulin resistance, promote ovulation, and restore fertility.
  • Laser hair removal: special parts such as the face, limbs affect beautiful, can cooperate with laser hair removal.

Will hirsutism relapse after cure? What about laser hair removal?

Generally does not relapse, and can achieve long-term curative effect; Only a few people will have a relapse, and the newly sprouted hair will become sparse and slender due to malnutrition. Therefore, laser hair removal will achieve good results.

Life

What Should Patients With Hirsutism Pay Attention To In Life

Can hirsutism give birth? Does it affect the child?

Some hirsutism is caused by other diseases, and children can be born according to the situation after active treatment of these diseases. However, if hirsutism is caused by malignant tumor (such as adrenal cancer), specialists should be consulted to weigh the pros and cons. Current technology cannot predict whether children will have problems.

How to nurse after laser treatment of hirsutism?

  • Immediately after treatment, ice bag was used for cold compress for half an hour.
  • Strict sunscreen after treatment, face with SPF 30/PA++~+++sunscreen products, and play a parasol or with a hat, other parts of the can wear long pants to cover, to avoid significant pigmentation after treatment.
  • Avoid consuming sensitive foods and medications, such as celery, figs, coriander, and vitamin A acids, during the treatment period.
  • On the second day of treatment, if there is no swelling, blisters and so on, you can take a shower normally, and you should try not to take a sauna or a hot bath. If there is any adverse reaction, you should see a doctor in time.

What should hairy patients pay attention to in life? Do you need any taboos?

  • Keep your mind at ease and try to adjust your emotions.
  • Avoid excessive plucking and depilation.
  • Eat less spicy excitant food and greasy food such as chili, raw garlic, raw onion, hot pot, etc.
  • Pay attention to rules in life.

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